De Dominicis E, Finocchi G, Sartori M, Vincenzi M
G Ital Cardiol. 1987 Mar;17(3):272-80.
We describe the case of a diastolic mitral and tricuspid regurgitation in a patient affected by acute myocardial infarction Ecg showed inferior myocardial infarction complicated by atrioventricular block and a junctional rhythm with frequent premature ventricular beats; the mean heart rate was of about 60 per minute. 2D echocardiogram disclosed akinesia of the apical segments of the inferior septum and anterior and infero-lateral walls. Pulsed and continuous wave Doppler showed mild to moderate mitral and tricuspid systolic regurgitation and diastolic regurgitation through both atrioventricular valves. The diastolic regurgitation always occurred during prolonged diastoles, soon after the blocked P waves. The possible mechanism of this finding and its clinical significance are discussed, drawing the conclusion that the atrioventricular diastolic regurgitation is not diagnostic of a specific valvular disease but can be secondary to other conditions, especially the atrioventricular block.
我们描述了一名急性心肌梗死患者出现舒张期二尖瓣和三尖瓣反流的病例。心电图显示下壁心肌梗死并发房室传导阻滞及交界性心律伴频发室性早搏；平均心率约为每分钟60次。二维超声心动图显示下间隔、前壁和下侧壁心尖段运动减弱。脉冲和连续波多普勒显示二尖瓣和三尖瓣有轻度至中度收缩期反流以及通过两个房室瓣的舒张期反流。舒张期反流总是发生在延长的舒张期，紧跟在受阻的P波之后。本文讨论了这一发现的可能机制及其临床意义，得出结论：房室舒张期反流并非特定瓣膜疾病的诊断依据，而是可能继发于其他情况，尤其是房室传导阻滞。
